Education and Early Childhood Learning

Children who are diagnosed with URIS Group B health care needs are eligible to receive support for a medical procedure or response to an emergency situation. The skills required to manage these needs can safely be delegated to non-health-care personnel trained and monitored by a registered nurse.

Children with Group B health care needs are a very diverse group. They may have one or more diagnosed disabilities (physical and/or neurodevelopmental), require assistive technology and/or have a temporary or life-long medical condition that requires special health care.

Group B health care needs that are eligible for URIS support are listed below.

• Anaphylaxis
• Asthma
• Bleeding disorders
• Cardiac conditions
• Clean intermittent catheterization
• Diabetes
• Endocrine conditions
• Gastrostomy care and feeding
• Osteogenesis imperfecta
• Ostomy Care
• Pre-set oxygen
• Suctioning (oral or nasal)
• Seizure disorder

For more information on these health needs, see Clinical Practice Guidelines.

Community programs are supported by registered nurses who are employed within regional health authorities. The URIS nurse will:

• develop and maintain a health care plan for a child that is eligible for URIS Group B health care support;
• provide on-site training to non-health-care personnel responsible for supporting the child;
• monitor non-health-care personnel on a scheduled basis to ensure that the competencies required to manage the health care needs are maintained.

The URIS nurse can delegate specific health care tasks to community program personnel under the circumstances described by the College of Registered Nurses of Manitoba (CRNM). See here for more information.

Children with URIS Group B health care needs require a written health care plan that is specific to them.

The health care plan will vary depending on the individual needs of the child. Guidelines and templates for the development of health care plans for URIS Group B health care needs can be found in the Clinical Practice Guidelines.

Children do not attend community program to receive health care. Rather, health care needs are addressed to support the child's participation in the program. The health care plan should reflect this and focus on the skills required to support attendance and participation.

The development of the health care plan is the responsibility of the registered nurse. It involves collaboration with the child/family, primary physician and other relevant members of the community and health care teams.

The registered nurse is responsible to review the health care plan a minimum of once per year or as needed to ensure it remains current. As the registered nurse responsible for developing the health care plan is not routinely in the community program, he/she must rely upon the child/family, primary physician and other relevant members of the community and health care teams to communicate changes in the child's health status as these changes may necessitate updates to the health care plan and further training.

The health care plan must be clear, concise and available to personnel responsible for the care of the child. Priority information should be prominently displayed. Supportive information, such as a step-by-step description of a procedure, should be included for reference.

The health care plan contains personal health information about a child. In accordance with The Personal Health Information Act (PHIA), community programs must respect the privacy of the child and family and adhere to the following guidelines:

• The information contained in the health care plan is confidential and may be accessed only by those individuals responsible for the care of the child in the community program (e.g., nurse, case manager, principal, teachers, educational assistant, special needs child care worker, etc.),
• The information contained in the health care plan should not be copied or shared with others without the permission of the parent/guardian agency.
• The health care plan should be stored in a designated area and safeguards must be in place to ensure that only those who require the information to provide care to the child has access to it.
• The health care plan remains the property of the community program. The family has access to the document and will receive a photocopy of it upon request.

The primary functions of community program personnel that are responsible for a child with URIS Group B health care needs include:

• participating in training provided by the URIS nurse;
• responding to the child's Group B health care needs as outlined in the child's health care plan and taught by the URIS nurse; and
• communicating challenges or changes to the child's health status or health care plan to appropriate personnel (e.g., case manager, administrator) within the community program.

URIS allows for delegation of Group B interventions to non-health-care personnel that receive training and monitoring from a URIS nurse. The training provided is child specific and cannot be applied to another child. Also, trained community program personnel cannot train another person on Group B interventions.

Children requiring URIS Group B support need an Individual Health Care Plan (IHCP).

The first step in the process is to share information with parents/guardians about URIS supports and ask whether the child is in need of these supports.

If yes, provide the parent/guardian with the URIS B application form.

The development of the IHCP is the responsibility of the nurse that is providing direct care to the child. This involves collaboration with  the child/family, primary physician, other medical supports and the team within the community program.

Children do not attend a community program to receive health care. Rather, health care interventions are performed to support the child's participation in the program. The IHCP should reflect this and focus on interventions required to support attendance and participation. It is intended to complement and work with other planning formats that are used in the community program (e.g., Individual Education Planning Process). Typically, a staff member of the community program (e.g., resource teacher/child care coordinator) is designated as case manager.

Evaluation and monitoring are integral to health care planning and to ensure the interventions are adequate and appropriate. Interventions must be tailored over time to allow for changes in health care status and developmental stages of the child. Maintenance of the health care plan involves ongoing collaboration by the nurse with the child and parent/guardian and a broad range of community and health professionals. The nurse responsible for direct care is also responsible to update the IHCP as needed to ensure it remains current.

The IHCP contains personal health information about a child. In accordance with The Personal Health Information Act (PHIA), community programs must respect the privacy of the child and family and adhere to the following guidelines:

• The information contained in the IHCP is confidential and may be accessed only by those individuals responsible for the care of the child in the community program (e.g., nurse, case manager, principal, teachers, educational assistant, special needs child care worker, etc.).
• The information contained in the IHCP should not be copied or shared with others without the permission of the parent/guardian agency.
• The IHCP should be stored in a designated area and safeguards must be in place to ensure that only those who require the information to provide care to the child have access to it.
• The IHCP remains the property of the community program. The family has access to the document and will receive a photocopy of it upon request.

1. Identify child’s health care needs to the community program.
2. Complete and sign the URIS Group B Application if their child has a health care need(s) that is eligible for Group B URIS support.
3. Participate in the development of the child’s health care plan.
4. Sign the child’s health care plan and return it to the community program.
5. Contact the nurse and/or community program if changes occur to the child’s Group B health care need(s).